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Two major computer networks, including Quebec's medicare database, had more outside consultants than bureaucrats working on them. Last September, the anticorruption unit, known as UPAC, charged one of its own bureaucratic partners with fraud for a suspicious laptop contract.

The AMPs require physicians to work an average of 12 hours per week in a "priority" service, such as an emergency room, a hospital ward, a rehabilitation centre or home care. Every hour that physicians spend fulfilling AMP requirements is an hour that they are not available at their primarycare clinic seeing their own family medicine patients. In addition to AMP hours and family medicine patient care, family physicians are also called to assume administrative duties and engage in medical teaching, both of which take time away from patient care. Bill 20 requires family physicians to register patients to their clinic with the intent of offering continuity of care, known as "prise-en-charge." This offers the patient a home base from which to seek health care, always first contacting that particular physician or group, as opposed to going to a walk-in clinic or emergency room, but physicians are to be penalized if too many of their patients choose to seek health care elsewhere, such as a colleague's clinic, a walk-in clinic or an emergency room. The law provides no exceptions if patients who live and work in two different areas seek health care from two different clinics, one near their place of work and one near their place of residence. Part-time physicians will be specifically punished, as they will not be able to provide continuity of care to the required number of patients. This includes physicians who are in the process of retiring and downsizing, working parttime due to personal or family reasons, on maternity leave, or on sick leave or disability.

That's nowhere close to the government's proposal of a twoyear salary freeze followed by three years of 1-per-cent salary increases. The Liberal government also wants to increase the age at which employees can begin collecting their pension without penalty from to 62 from 60.

Mr. Letourneau stressed essential services are being maintained and the goal of public-sector workers is to put pressure on the Quebec government through provincewide pressure tactics. About 400,000 workers are represented by the so-called Common Front, which comprises two of Quebec's largest labour unions as well as the union of public employees.

The public-sector collective agreements expired at the end of March and the unions have promised to keep up the pressure if the government is unwilling to deviate from its current position. On Monday, some of the larger demonstrations were held in the Outaouais region near Ottawa as well as in the Lanaudiere and Laurentians regions north of Montreal.

Another difficulty is ideological resistance to such innovations as increased private health service delivery and performance-based funding

Claude Castonguay, under whose direction Quebec’s medicare system was instituted four decades ago, has written a new book

In an open letter to the premier published this week, he says that what is needed is an overall plan

choices than British Columbians or Quebecers do," answered Kenney. Health Minister Sarah Hoffman has an answer: if Kenney wants a policy brawl over the injection of more private options, he's welcome to it. "I'm not surprised that he's trying to find ways to expand privatization in the health-care system," she said in an interview. "Certainly, that's unfortunate." As you'd expect from a federal Conservative, Kenney blames centralized decision-making. "I just believe that local management of resources is a lot more sensible than hyper-centralized control," he told the Herald. "You know, when hospitals are given a limited budget for a limited number of hours they can service people, that gets out of alignment with the actual local demand."

But Hoffman figures Albertans don't want another major shift in how health care is run, after watching a pack of failed experiments in the PCs' waning years. She has doctors and officials working on two related problems - how to get more use out of the city's publicly owned MRI machines, and how to make sure everyone on the list really needs the test. I asked if she eventually plans to fold the province's vast array of private clinics, including imaging centres, under the government wing through public ownership.

We're not planning on doing a full overhaul," she said. "In general, Albertans are proud of what we've got. I don't have any drastic plans for changing the way those programs are administered." As often happens, when you sift through the rhetoric the opponents are quite close together. Most New Democrats would agree with another Kenney statement (as long as they're weren't aware who said it): "We need to ensure our health care has adequate funding, that it's publicly administered, that it's universally available, that it complies with the Canada Health Act." The key point is not who owns the assets, but who pays the bill. If health care pays, it hardly matters whether you get the test in a public hospital or a private clinic.

The MRI dispute is a good example of how the public-private debate has become so futile and misleading. Nine MRI machines in Calgary are publicly owned. They perform the tests for people on the waiting list. But there are also three MRIs in privately owned clinics.

The province doesn't fund MRI tests in those private clinics. The PCs wouldn't, and now the NDP won't either. And yet, health care funds virtually every other imaging test, including X-rays, ultrasounds and mammograms. Those exams are done every day in the very same clinics that own the private MRIs. The cost of a private test is $750, which probably explains why those machines are underused despite the long public wait.

Simple answer, right? The province should just start funding tests on the private MRIs. Asked why she doesn't do that, Hoffman says, "Why would you pay to rent something when you already own it and you're only using it half the time?" OK then, why not use what you've got? Why does that have to be so ridiculously difficult? Health care in Alberta is extraordinarily complex, and because of that, far beyond the reach of simplistic rhetoric about private and public delivery. That debate is just a distraction from the real issue - making the system work. Do that, please. Don Braid's column appears regularly in the Herald dbraid@postmedia.com

Then there's little Meghan Arnott, age 12, who's waiting for surgery in British Columbia to correct a complication brought on by Crohn's disease. Unfortunately for Meghan, she's been told her surgery may have to be postponed eight or nine months due to a severe shortage of nurses in B.C., caused by-you guessed it-chronic underfunding of our health-care system by the government. Meanwhile, this young girl waits in excruciating pain and discomfort, yet another invisible victim of Medicare.

Or how about 16-year-old Walid Khalfallah, who hails from Kelowna, British Columbia? Walid is now a paraplegic thanks to his encounter with our health-care system. All because those running the show felt it was a reasonable risk for a young boy of 13 to wait 27 months-that's right, folks, I said 27 months-for surgery on his spine. By the time Walid had the surgery in 2012, at Shriners Hospital in Spokane, Washington, it was too late.

Still think we have the best health-care system in the world? Not by a long shot. Despite statements by elected officials to the contrary, Canada's health-care system is no longer something we Canadians can-or should-be proud of. Stories like those of Laura, Meghan and Walid, while admittedly anecdotal, point to inadequacies in how Medicare is funded and how decisions are made when it comes to deciding on what programs receive funding and which don't.

It's sort of like winning the lottery. If you belong to a demographic that is older and more inclined to vote-baby boomers, for example, in need of cataract surgery or hip replacements-then you might very well be in luck. If you happen to be a child, however, or suffering from some less-than-"sexy" disease, then good luck, you're on your own.

No one's life should have to depend on the roll of the dice. That's crazy. Fortunately, after years of delays and legal maneuvering by the B.C. Government, Dr. Brian Day's charter challenge is finally about to get under way this coming September in Vancouver. The case, which will be argued before the Supreme Court of British Columbia, will include six other plaintiffs, including Walid Khalfallah, in addition to Dr. Day. Sadly, two of the six plaintiffs have died as a result of delayed access to care. The irony of that should be lost on no one.

In 2005, the Supreme Court of Canada ruled that those living in the province of Quebec should have the right to purchase private health-care insurance under the Quebec Charter. This was known as the Chaoulli case. Dr. Jacques Chaoulli successfully convinced all seven judges hearing the case that patients were suffering and, in some cases, dying while waiting to access care. Dr. Day and his fellow plaintiffs will be arguing that those living outside Quebec should have similar protection under the Canadian Charter of Rights and Freedoms.

Not surprisingly, the B.C. Government and Government of Canada will be arguing the opposite, as will a number of special interest groups, including representatives of the B.C. Health Coalition and Canadian Doctors for Medicare, who have applied for and been granted intervener status. While I have no doubt that Dr. Day will ultimately win his charter challenge-after all, Dr. Day and those representing the more than two million Canadians currently suffering on waiting lists, including Walid and the other five plaintiffs, are on the side of the angels. As for all those bureaucrats, lawyers and elected officials-armed with an endless supply of "lies, damn lies, and statistics," desperately trying to justify maintaining the status quo-I'm not really sure whose side they're on.

Certainly not yours or mine. Because if they were, they'd come clean and admit the truth. Canada's health-care system is not sustainable and on the verge of complete and total collapse. Spending millions of dollars to defend the indefensible is not only wrong, it's obscene. Just ask Laura, Meghan, Walid and the friends and relatives of the two plaintiffs who died after waiting for both care and justice. Access to a waiting list is not access to care, as the judges in the Chaoulli case so rightly pointed out 11 years ago. Hopefully, when the decision is handed down, once all the arguments have been heard this fall in British Columbia, we'll finally be able to have that "adult" conversation we've been avoiding for the past 20 years and actually do something to fix the mess we find ourselves in. One can only hope. Stephen Skyvington

Quebec ombudsman Raymonde Saint-Germain has found that while Quebec's home-care policy does not allow the government to deprive anyone of home-care services, some people needing help to remain in their homes are excluded, others have their service reduced, waiting lists are getting longer and caregiver burnout is growing among family members.

CSSSs - Centres de santé et de services sociaux - and the CLSCs under their wings, do not have enough money to provide the necessary care

Staff hired to take care of people in their homes are let go to balance CLSC budgets.

Bolduc will present an action plan in June.